Precariously-housed communities experience premature mortality and high rates of co-morbid illness, including cSVD, stroke, and depression, representing an urgent public health challenge. There is limited understanding of the relationship between cSVD and depression in this group. Recent studies have examined depressive symptoms as a complex dynamic system, suggesting greater connectivity may drive disease progression.

This study is part of a prospective community based study of mental and physical health (n=408) of precariously-housed adults in Vancouver, Canada. Depressive symptoms were measured by the Beck Depression Inventory (BDI). Participants received T1, T2-FLAIR, and SWI 3T MRI sequences. The cSVD burden was characterized using a modified score, with one point each for moderate-severe white matter hyperintensities, cerebral microbleeds, and lacunes. Participants were divided into groups with (n=103) and without cSVD (n=305). Network analysis was used to investigate relationships between depressive symptoms. Walktrap algorithm was used for community detection. Permutation procedure compared the global and local network structure between groups.

Participants with cSVD burden had similar total BDI scores than those without (p=0.523). Among those with cSVD , sleep disturbance and feeling punished demonstrated the greatest degree and betweenness centrality. Three communities of symptoms were identified. Global connectivity was similar between the two networks (p=0.524). Several edges differed between groups, including a positive edge between indecision and suicidal ideation among those with cSVD.

 While total depressive symptom scores or global connectivity of depressive symptom networks were similar in those with and without cSVD, the network architecture differed, with potential implications for clinical onset and progression among precariously-housed adults. The complex relationships between cSVD and depressive symptoms require consideration when caring for precariously housed persons.